Practica Oto-Rhino-Laryngologica

Hearing and Vestibular Impairment in Cerebral Palsied Children

Koichiro Higashi, Shizuko Sasaki

1979 Volume 72 Issue 7 Pages 857-861
Published: July 01, 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.857

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We performed pure tone audiometry, observation of nystagmus and caloric test on 51 cerebral palsied children. There were 31 spastics and 17 athetoids, the remaining two showed spastic paresis with striking tremor.
1. Pure tone audiometry: 15% of spastics and 50% of athetoids represented sensory-neural hearing loss.
2. Nystagmus: Gaze, positional and positioning nystagmus were observed. We found nystagmus in 39% of spastics and 56% of athetoids. One of spastics and three of athetoids had sporadic nystagmus-like eye movements, which were not directed to any fixed direction and had a large amplitude.
3. Caloric test: 12 of athetoids and 28 of spastics could be examined. We found CP or DP in 18% of spastics and 17% of athetoids.

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Vestibular Nystagmus Inhibition Caused by Eye-closure

Setsuko Takemori

1979 Volume 72 Issue 7 Pages 863-869
Published: July 01, 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.863

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When the eyes were closed, the eyes were suddenly adducted 13±5° and elevated 55±11° in 24 normal adults. These movements were also seen with eyes closed during caloric nystagmus, one form of vestibular nystagmus. Caloric nystagmus was strongly inhibited by eye-closure and its inhibition depended on the degree of eyeball elevation caused by eye-closure. With a turning down of the vertical eye position, caloric nystagmus inhibition was released.
Disturbances in eyeball elevation during eye-closure were seen in the following cases.
1. Disturbance in eyeball elevation itself was seen in cases of oculomotor palsy.
2. Sudden turning down of eyeball elevation was seen in cases of sudden loss of inner ear function, cerebellar diseases, lateral pontine lesions and of cerebral lesions.
3. A gradually increase in eyeball elevation was also seen in cases of epilepsy, etc.

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Otosclerosis -Cases with Postoperative Sudden Loss of Hearing-

Haruo Saito

1979 Volume 72 Issue 7 Pages 871-874
Published: July 01, 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.871

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Ear surgeons are now performing stapedectomy on Japanese more frequently than before, therefore, problems related to this operation have to be given attention.
The author experienced three cases of sudden hearing loss after the initial success and the suspected causes were confirmed at revision operations.
One was the reobliterated oval window by the active foci, as revealed in the specimen taken at the first operation.
The second was a slipped prosthesis (Fat-wire), which led to a perilymphatic fistula.
The third was a perilymphatic fistula around the prosthesis (Tefon-wire). This patient had fluctuant hearing loss and imbalance before the sudden loss of hearing.
Hearing ability after revision operations was unsatisfactly in all cases and in the last case the hearing deteriorated to total deafness.
Thus close care should be taken as to the selection of patients for surgery, surgical procedures, and postoperative management in order to avoid sensori-neural deafness.

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Extended Basal Cell Carcinoma in the Facial Region

Shigeru Tsumura, Hiroaki Takahashi, Toru Nakajima

1979 Volume 72 Issue 7 Pages 875-879
Published: July 01, 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.875

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The patient was a 75-year-old male who had had a congenital small mole on his right nasal ala. Ten years previously, the mole became tumor-like and began to invade the surrounding tissue. A series of treatments including radiation were without effect, and when he was first examined in our clinic his right upper facial region had been almost completely destroyed. Histological examination revealed the lesion to be basal cell carcinoma.
Radical surgery including right ophthalmectomy was performed. No recurrence and local metastasis were observed until he died one and a half years later.
Through the experience of this case the authors concluded: Since basal cell carcinoma of the facial skin shows very mild extension without metastasis, early surgery is the treatment of choice, and the resulting defect on the face can be easily treated by plastic surgery at this stage. When the surgery is not readily performed, massive destruction of the tissues takes place and the reconstruction surgery becomes impossible.

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Rhabdomyosarcoma Originating in the Right Parotid Gland in a Ten Year Old Girl

Masanori Morimoto, Kazuo Makimoto, Mariko Yamasaki, Toshiko Yoshinobu, ...

1979 Volume 72 Issue 7 Pages 881-887
Published: July 01, 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.881

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A rare case of rhabdomyosarcoma of the parotid gland was seen in a ten year old girl admitted with complaints of painless and gradually growing lumps in the right parotid region. A biopsy of the parotid tumor showed a embryonal type of rhabdomyosarcoma. About one month after admission, the patient developed a metastasis to the tenth thoracic vertebra.
The multimodal treatment consisted of radiation therapy with 5500 rads to the primary lesion and 4500 rads to the tenth thoracic vertebra, and chemotherapy with vincristine, cyclophosphamide, actinomycin D, predonisolone and doxolubicin.
In the earlier period of this treatment, the parotid tumor responded well, but in a short time the tumor again increased in size. The clinical course rapidly deteriorated and she died ten months after the first evidence of the lumps.

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Acinic Cell Carcinoma of the Oral Palate

Yoshiharu Igarashi, Akio Imai, Hatsuo Ino, Isamu Takeyama

1979 Volume 72 Issue 7 Pages 889-895
Published: July 01, 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.889

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The patient, a 67 year old female complained of swelling in the oral palate for the last three months, but she denied any pain in the lesion. There was no evidence of enlarged lymphnodes or metastasis. The tumor was resected and its surrounding soft tissue revealed an acinic cell carcinoma of the oral palate. Despite irradiation therapy after the first operation, (total dose 4500 rad for three weeks, ) local recurrence was noted without a sign of metastasis. A second radical operation was then performed. The resected area consisted of the original tumorous site and the surrounding healthy soft tissue of the oral palate and also included part of the bony oral palate. At the same time, the first staged plastic operation of the oral palate was done to prevent speech disturbance.
The patient had a good clinical course without recurrence, metastasis or remarkable speech disturbance.
According to our study, only 18 cases of acinic cell carcinoma of the minor salivary glands have been reported in the literature.

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A Case of Hashimoto's Thyroiditis With Ectopic Thyroid Gland

Hiroshi Miyahara, Yuhko Kitao

1979 Volume 72 Issue 7 Pages 897-904
Published: July 01, 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.897

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A 63-year-old-female with Hashimoto's thyroiditis with ectopic thyroid gland had complained of struma and median cervical tumor. She was examined and treated in Kumamoto University Hospital. Laboratory data concerning thyroid function were within normal range and thyroid scintigram showed ¹³¹I uptake by a median cervical tumor in the right upper region of the thyroid gland.
Right hemithyroidectomy and excision of the median cervical tumor were performed. Pathohistologically Hashimoto's thyroiditis was observed in every specimen. Postoperatively the thyroid function tests revealed slight elevation of TSH.
Clinically ectopic or aberrant thyroid glands are rare and usually occur at root of the tongue or in the intrathoracic region.

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Cryosurgery for Hemangioma

Toshiaki Ogawara, Masayuki Kajihara, Yu Masuda, Ryusuke Saito, Yoichi ...

1979 Volume 72 Issue 7 Pages 905-909
Published: July 01, 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.905

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Hemangiomas in the field of otorhinolaryngology are now being treated by many methods. In recent years, cryosurgery, which utilizes liquid nitrogen, is popular and good results have been produced. We encountered 13 patients with hemangioma and have used cryosurgery in 9. Recently, the cryosurgery in our clinic is being practiced under the conditions of three minutes and a two times application at —180C. Cryosurgery has the advantage that the operation is easily facilitated, there is little bleeding and pain, it can be practiced repeatedly, and there is little transformation and little functional disturbance. In our 13 patients, 9 benefited from this surgical approach.

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Therapeutic Effect of Roin Fine Granules on Tinnitus

Observation on 25 Cases of Craniocervical Trauma

Kazuhito Nakanishi, Kazuo Makimoto, Shinsuke Ito, Fujiko Izumikawa

1979 Volume 72 Issue 7 Pages 911-917
Published: July 01, 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.911

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Roin Fine Granules were used for the treatment of tinnitus in 25 cases of craniocervical trauma (including 17 cases of head injury and 7 cases of whiplash injury) and the therapeutic efficacy of the preparation was assessed by questioning of the patient and by utilizing pertinent otologic tests. The results indicated that the drug was markedly effective in 11, effective in 5 and ineffective in 9, with a total effectiveness rate of 64%.
The effectiveness rate for the drug was higher in younger patients (under 50) than in the elderly and also in patients with a duration of illness of less than one year, as compared to those who had been ill for over one year.
It was also demonstrated that patients exhibiting a score of type I or II on CMI test had a definitely higher effectiveness rate for the drug than those displaying a score of type III or IV on the same test.
From these results it was concluded that Roin Fine Granules provide a remedy of salient usefulness for tinnitus following injuries of the head and neck.

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Effect of 2% Nasal Solution of Disodium Cromoglicate on Perennial Nasal Allergy

Double-blind Trial

Minoru Okuda, [in Japanese], [in Japanese], [in Japanese], [in Japanes ...

1979 Volume 72 Issue 7 Pages 919-941
Published: July 01, 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.919

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The effect of 2% nasal solution of disodium cromoglicate (DSCG) was investigated in a joint doubleblind study carried out at 10 hospitals, in 160 patients with perennial nasal allergy. The effectiveness and safety of the compound were studied and compared with those of placebo. The test solution was sprayed 1 squeeze per nostril, six times daily, for four weeks.
DSCG was significantly superior to the placebo; three subjective dominant symptoms in nasal allergy, sneezing, watery discharge and nasal blockage almost equally improved, and also objective parameters such as swelling and colour of the mucous membrane, volume and characteristics of watery discharge, nasal provocative reaction and eosinophils in nasal smear improved. Global improvement rating with DSCG was 79.7% after two weeks of treatment and 91.7% after four weeks.
The effect of DSCG appeared as early as the first week in 53.2% of the patients and was maintained for at least two weeks after discontinuation.
The above effect was confirmed by the global assessment of the doctors, the patient's judgement, analysis of diary cards and by combined judgement according to fixed criteria. DSCG was effective irrespective of background factors such as sex, age, type, severity, dominant allergen, complementary allergen, duration of disease, history of disease, history of treatment, season, reactivity in nasal provocation and skin test, eosinophils in nasal smear and rhinoscopic findings.
As side effects, nasal irritation, headache and epistaxis were observed in 6.8% of the patients. All of the symptoms were mild and transient, and did not require discontinuation of treatment.
DSCG solution seems to be equally as effective as the powder form and is more easily applied than the powder form, particularly in young children.

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Chinese Medicine (Kampo) and Allergic Rhinitis

Kazuhiko Sasaki

1979 Volume 72 Issue 7 Pages 943-947_1
Published: July 01, 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.943

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In 50 patients with an allergic rhinitis, the Chinese herb “Shoh-shei-ryuh-toh” was effective in 84 per cent. The efficacy of this compound was evident in 2-4 weeks, and in patients on the drug for 3-6 months, the nasal symptoms decreased considerably or disappeared altogether. The only side-effect was a slight abdominal swelling (subjective) in one patient.

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Intravenous Olfaction Test with Alinamin F

Masao Shinomiya, Masahito Tange, Yoshiaki Okuno, Hidehiko Sasa

1979 Volume 72 Issue 7 Pages 949-955
Published: July 01, 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.949

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Alinamin is routinely used for the intravenous olfaction test. We attempted to elucidate whether Alinamin F, which has a less pungent odor than Alinamin may be used. Results were as follows;
1) There were no significant differences in both latent time and duration time between 10mg of Alinamin and Alinamin F. Alinamin F seemed to have a 1/10-1/100 fold stronger odor.
2) In patients with olfactory-related disturbances, the test (latent time and duration time) with Alinamin F corresponded to these factors seen with Alinamin at a rate of 60%.
3) Many patients made a good prognosis, even if the duration time with Alinamin F was 20 sec. or less.
4) The prolonged time seen with Alinamin F seemed to account for the effective treatment.
Thus, Alinamin F may be used for evaluating the prognosis and effects of treatment, in combination with Alinamin.

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Analysis of Associated Movements in Recovery Process of Peripheral Facial Palsy

Hiromu Mori, Kazuaki Kitahara, Michiyuki Kita, Haruo Takahashi, Yoshih ...

1979 Volume 72 Issue 7 Pages 957-964
Published: July 01, 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.957

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One of the commonest sequelae of peripheral facial palsy is associated movements of one part of the face on voluntary movement of another part. An integrative EMG analyser (Medelec Co.) was used for examination of associated movements of 41 patients with facial palsy who visited the ENT clinic at our hospital. Abnormal associated movements were recorded the most frequently in the orbicularis oculi muscle (57%), and subsequently in the frontal muscle (53%) and the orbicularis oris muscle (47%) Utilization of this analyser makes feasible a quantitative differentiation of abnormal associated movements from normal physiological associated movements of facial muscles. The period of onset, and the process and recovery of associated movements can also be routinely analysed using this equipment.

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Fiber Analysis of Human Gustatory Nerve

Yoshiharu Igarashi, Kanemasa Mizukoshi, Tetsuo Ishii

1979 Volume 72 Issue 7 Pages 965-969
Published: July 01, 1979
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.72.965

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Human gustatory nerves, such as chorda tympani, lingual nerve and sensory component of glossopharyngeal nerve innervate the tongue and play a role in taste, pain and other senses. The gustatory nerves are regarded as a particular sensory nervous system, but the size (diametor) and the distribution of nerve fibers in those gustatory nerves have been little understood, especially in human materials.
We attempted to analyse the number, size and distribution of the representative human gustatory nerves— lingual, glossopharyngeal and chorda tympani, and to compare findings with those seen in motor nerves. The materials were obtained at the time of surgery; a part of the lingual nerve and the glossopharyngeal nerve from a 68 year old female suffering from lingual pain and the chorda tympani from a 6 year old child and 38 year old male with chronic otitis media. After the preparation of those materials by fixation and sectioning in the microtome, the nerve fibers were photographed, an the diameter measured and a count made of the total number of total nerve fibers. The result showed that the chorda tympani consisted of mainly small fibers (less than 4 microns) and the lingual nerve and the glossopharyngeal nerve included larger fibers (4-8 microns) as well as small fibers. Thus the gustatory nerves have a significantly different composition of nerve fibers as compared to motor nerve.

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